Adenotonsillectomy Linked to Increased Risk for Childhood Obesity

A new study claims that adenotonsillectomy (T&A) is associated with weight increase and may contribute as a risk factor for childhood obesity.

Researchers at Saint Louis University (MO, USA) conducted a systematic review of literature via PubMed and Ovid, performing a systematic analysis of data from 1970 to 2009 regarding patients who underwent T&A, with preoperative and postoperative weight-based measurements. A total of 795 children satisfied study criteria, and of these, 656 children had demographic information recorded; 53.35% of the children were male. The recorded indication was sleep-disordered breathing in 47.7% of patients.

The results showed that in the first group of three studies, enrolling 127 children, body mass index (BMI) increased by 5.5% to 8.2%. In the second group of three studies, enrolling 419 patients, standardized weight scores increased in 46% to 100% of patients. In the third group of three studies, enrolling 249 patients, corrected weight increased postoperatively in 50% to 75% of patients. Weight was unchanged postoperatively in morbidly obese patients, defined as those with weight 130% to 260% of that expected in their peers. The study was published in the February 2011 issue of Otolaryngology–Head and Neck Surgery.

"Although it is important to treat pediatric obstructive sleep apnea and chronic tonsillitis appropriately with T&A, the decision for surgery in normal and overweight children must be tempered with the real possibility that T&A could cause further overweight and obesity,” concluded lead author Anita Jeyakumar, MD, and colleagues of the department of otolaryngology. "Obviously further studies are needed to determine which children may be at greatest risk for developing overweight and obesity. Regardless, a healthy diet and exercise should be implemented to treat overweight and obese children.”

Tonsillectomy is a 3,000-year-old surgical procedure in which the tonsils are removed from either side of the throat. The procedure is performed in response to cases of repeated occurrence of acute tonsillitis or adenoiditis, obstructive sleep apnea (OPA), nasal airway obstruction, snoring, or peritonsillar abscess. Tonsillectomy is often performed together with adenoidectomy, the surgical removal of the adenoids. This may be done for several reasons, including impaired breathing and chronic infections or earaches.

Related Links:
Saint Louis University